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Catch up on the top stories in optometry during the week of April 28-May 2.

Takeaways from this week in optometry: April 28 - May 2

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With the acquisition, Topcon Healthcare also assumes RetInSight’s AI algorithms that analyze retinal images to detect and monitor disease.

Topcon Healthcare acquires RetInSight to fuel AI in retinal disease diagnosis, monitoring

While the study included a range of subjects in a variety of stages of presbyopia, the change in crystalline lens geometry and anterior segment was most pronounced in emmetropic and myopic presbyopes.

ARVO 2025: New research reveals new marker for presbyopic accommodation

The CATHAY trial evaluated 186 myopic children, 6 to 13 years old at initiation, across 5 hospitals. 

SightGlass Vision studies find DOT spectacle lenses as highly effective for myopia management, show no evidence of rebound

The leading source of breaking news, news analysis, and emerging research reports in optometry, Optometry Times® disseminates practical content by optometrists for optometrists that can be immediately applied to improve the clinical experience.

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In this episode, four expert faculty talk about the importance of early diagnosis and treatment of thyroid eye disease. They discuss the differential diagnosis, screening tests, and the need for multidisciplinary management for these patients.

Expanding the treatment arsenal in glaucoma management

Matt Jones, OD; Matt Burns, OD; and Joe Sugg, OD; detailed what optometrists can expect to change when HB 1353's regulations are enacted later this year.

Arkansas' passage of HB1353 received well by optometrists in the state

A significant change is coming through new legislation that grants the Department of Insurance expanded authority to regulate vision benefit managers (VBMs). HB 1353 brings VBMs under the health benefit plan definition, providing regulators with more oversight capabilities that weren't previously available. Arkansas Optometric Association legislative cochairs Matt Jones, OD, and Joe Sugg, OD, and executive director Matt Burns detailed what optometrists can expect to change when the new regulations are enacted later this year.

The association will be implementing educational resources to help doctors with this transition, ensuring companies follow the law in coordination with the Department of Insurance. Doctors will need to be proactive in filing complaints with the Arkansas Insurance Department when violations occur.

The bill addresses several crucial areas:

Prevents discriminatory reimbursement based on buying groups or business models

Eliminates mandatory product routing to specific labs

Prevents patient steering to distant offices

Prevents reimbursement through credit cards

Protects against retroactive payment reversals when eligibility was confirmed

The feedback has been overwhelmingly positive concerning HB 1353 from legislators, optometrists, and ophthalmologists. Sugg, Jones, and Burns cited that optometrists feel the playing field has been leveled, allowing them to prioritize the doctor-patient relationship. The bill has also received support from across the medical community.

The legislation aims to level the playing field between VBMs and optometrists, make it more attractive for optometrists to accept these plans, improve patient access to care, enhance patient choice, and create better conditions for optometrists contracting with these plans to practice.

The success of such initiatives relies on professional unity and participation. Jones said he encourages other optometrists in and outside the state to join their state and national associations, support their state leaders working behind the scenes, get involved in grassroots efforts, and contact state association executive directors for involvement opportunities

Matt Jones, OD; Matt Burns; and Joe Sugg, OD; detailed what optometrists can expect to change when HB 1353's regulations are enacted later this year.

Arkansas' passage of HB 1353 received well by optometrists in the state

Arkansas Optometric Association legislative cochairs Matt Jones, OD; Matt Burns, OD; and Joe Sugg, OD, discuss their involvement in their bill and provide context for its relevance. 

Arkansas Optometric Association outlines its latest legislature success in HB 1353

Starting in August 2025, with additional provisions to roll out based on plan renewals, contract changes, or by January 1, 2026, the relationship between optometrists and vision benefits managers (VBMs) will be changing in the state of Arkansas. HB 1353 will work to rebalance providers’ interactions with VBMs by expanding regulations and implementing more extensive reimbursement requirements. Joe Sugg, OD and Matt Jones, OD, legislative cochairs with the Arkansas Optometric Association (ArOA), and Matt Burns, ArOA executive director, sat down with 

to discuss the new legislation. They emphasized how the association provides a unified platform for optometrists to address industry challenges collectively. 

The key motivations behind the bill stem from long-standing issues in vision care contracts. Optometrists have been facing increasingly restrictive "contracts of adhesion" with vision plans, where providers have minimal negotiation power. These contracts have consistently squeezed independent practitioners, particularly regarding reimbursement rates that have remained stagnant despite rising operational costs. Sugg and Jones, who have both been private practice owners since 2009, detailed how vision benefit managers have been vertically integrating the market by consolidating frames, labs, electronic health records, and e-commerce platforms. This consolidation creates significant pressure on small business owners and limits their competitive capabilities. 

The bill's development involved collaboration with the American Optometric Association (AOA) and leaders nationwide. Their goal was to create legislation that would protect eye care providers and improve patient access. The speakers noted similar legislative efforts in states like Texas and Oklahoma, expressing hope that the Arkansas bill might inspire nationwide reform. When presenting the bill to legislators, they found surprising receptivity. Lawmakers quickly understood the parallels with pharmacy benefit manager regulations and recognized the need to protect small businesses. The bill's core principles seemed inherently logical to legislators – advocating for provider rankings based on quality of care rather than product sales. Jones highlighted the bill's consumer-friendly nature, arguing it would steer patients toward practices based on medical care quality instead of product sales. He also pointed out the stark reality that service reimbursement rates haven't increased since vision plans' inception, despite exponential increases in operational costs. 

Nationally, Jones and Sugg expressed optimism about potential federal legislation like the DOC Access Act, which could address similar issues in vision and dental insurance markets. Jones, Sugg, and Burns ultimately portrayed the bill as a critical step in protecting optometric practices and ensuring fair, patient-centered health care delivery.

Arkansas Optometric Association legislative cochairs Matt Jones, OD; Matt Burns; and Joe Sugg, OD, discuss their involvement in their bill and provide context for its relevance. 

Members of UPTE-CWA 9119 and the American Federation of State, County, and Municipal Employees (AFSCME) unions are holding unfair labor practice strikes at all University of California (UC) locations on May 1.

 The strikes follow UC’s hiring freeze implemented on March 19.

UPTE has agreed to return to the bargaining table on May 8 and 9 after receiving an improved proposal from UC on reclassification, according to the union.

 Additionally, the UC’s “last, best, and final” contract proposals were offered to employees represented by AFSCME that was sent on April 30.

 UC, UPTE, and AFSCME have been bargaining since January 2024.

After UC implemented its hiring freeze, UPTE submitted a cease and desist and demand to bargain. According to the union, UC would not undo the hiring freeze and thus did not reach their terms to negotiate. “Despite our repeated outreach and willingness to negotiate, UPTE continues to decline our invitations to return to the bargaining table,” UC said in a statement.

UPTE stated that the freeze had been implemented without providing the union notice, which did not allow an opportunity to bargain regarding the freeze.

 UC stated that the freeze only applied to future hires and would not impact the employment status of current UC employees.

“UC continues to act with impunity, and we can’t let them get away with it – especially when the hiring freeze and leaving workers at new hospitals behind will only worsen already dire conditions for patients, students, and research,” the union said in a statement released on April 15. “UC executives’ refusal to protect frontline staff and essential services makes our campaign even more important.”

UC has agreed to UPTE’s proposal for an initial response to reclassification requests within 90 days, which UPTE calls “a significant improvement from having no timeline in our current contract and UC’s initial proposal of 210 days.” UPTE claims that UC has otherwise not agreed to address “the lack of clear and objective criteria or an enforceable appeals process: UC still proposes unilateral control over the criteria and decision for reclassification.” The union also stated that more time off, improved job security, and fair pay have not been adequately addressed by UC and that the university is still proposing the right to increase healthcare premiums without limit.

AFSCME last, best, and final contact proposals

According to a news release, the last, best, and final offer (LBFO) meets the union’s original demand of $25 an hour and a 5% wage increase. The offer is projected to raise AFSCME salaries to more than $3 billion by the end of the proposed 5-year contract, representing an increase of nearly $600 in wages since the end of the last contract. The offer is also $113 million higher than UC’s initial offer made in February 2024.

“Despite the challenging fiscal environment created by recent federal and state budget constraints, we remain committed to fairly compensating our dedicated workforce,” said Associate Vice President for Systemwide Labor and Employee Relations at UC Missy Matella, in the release.

 “This offer represents our ongoing investment in our most valuable resource—our people—while we continue to navigate budget realities.”

For current median hourly rate, ambulatory care clinics, clinical support services, and patient support services would see a 19.33% increase. Ambulatory care employee wages would increase from $39.62 to $47.27 from the current rate to year 5, clinical support services from $36.04 to $43.00, and patient support services from $37.39 to $44.61.

“In a time of potentially catastrophic state and federal funding cuts, we have increased our last best and final offer to support UC’s workforce,” Matella said in the release.

 “We hope to finalize this agreement and collaboratively address other important matters, like the reduction of federal and state support.”

UPTE is going on an unfair labor practice strike across the UC system on May 1. UPTE-CWA 9119. Accessed May 1, 2025. 

https://upte.org/updates/upte-is-going-on-an-unfair-labor-practice-strike-across-the-uc-system-on-may-1

Fact sheet: AFSCME contract negotiations. University of California. Accessed May 1, 2025. 

https://www.universityofcalifornia.edu/sites/default/files/2025-04/AFSCME%202025%20Fact%20Sheet.pdf

Bargaining on May 8 and 9: We need to keep up the pressure! UPTE-CWA 9119. Accessed May 1, 2025. 

https://upte.org/news/bargaining-on-may-8-amp-9-we-need-to-keep-up-the-pressure

UC offers AFSCME last, best, and final contract proposals. News release. University of California. April 30, 2025. Accessed May 1, 2025. 

https://www.universityofcalifornia.edu/press-room/afscme-lbfo

University of California. Statement on AFSCME and UPTE bargaining. April 15, 2025. Accessed May 1, 2025. 

https://labor.universityofcalifornia.edu/_files/statement-on-afscme-upte-may-1-strike-notice.pdf

The strikes follow the University of California’s hiring freeze implemented on March 19.

UPTE-CWA 9119, AFSCME unions cite UC's "unfair labor practices" in May 1 strikes

Eva Kim, MD, shares visual outcomes of EVO implantable collamer lens in patients with low to moderate myopia

EVO ICL in Low to Moderate Myopia: A Refractive Option Worth Equal Consideration

As the landscape of refractive surgery continues to evolve, many optometrists are seeing increased interest in the EVO implantable collamer lens (ICL) (Staar Surgical) as a primary option—not just for high 

, but now for low to moderate myopia as well. Eva Kim, MD, cataract and refractive surgeon and uveitis specialist based in Deconfnver, Colorado, spoke on EVO ICL at ASCRS 2025, in Los Angeles, California. 

One of the most significant advantages of the EVO ICL, Kim emphasizes, is its reversibility. "It’s an additive procedure," she explains. "We're placing a custom lens inside the eye to provide outstanding vision, and if for any reason a patient wants it removed, we can return the eye to its original state." This concept is particularly appealing to younger patients who may be hesitant to commit to a permanent structural change to their cornea.

Importantly, at Kim’s practice, EVO ICL is not framed as a backup or secondary option to LASIK. Instead, both procedures are presented as equally strong choices, allowing patients to weigh their benefits. Interestingly, more than 50% of patients who qualify for both procedures are opting for EVO ICL—largely due to its reversibility and non-invasive perception.

The design of the EVO ICL also contributes to a superior safety profile. One major improvement over earlier ICL models is the elimination of the need for a preoperative peripheral iridotomy, which traditionally required a laser treatment that could be uncomfortable and invasive. Without this step, the patient experience is significantly streamlined and less intimidating.

In terms of postoperative recovery, Kim notes that while visual clarity on the day of surgery may be compromised due to dilation, most patients experience a dramatic improvement in vision the very next morning. Recovery is similar in timeline to LASIK—typically 1 day to 1 week—but patients tend to report greater comfort and fewer dry eye symptoms, making the healing process smoother overall.

As optometrists guide patients through their refractive surgery options, the EVO ICL offers a highly viable and increasingly popular alternative to LASIK—even for patients with mild myopia. With its strong safety profile, reversibility, and high patient satisfaction, it deserves a central place in today’s refractive care conversation.

Eva Kim, MD, offers valuable insights into why EVO ICL is becoming a compelling alternative to traditional corneal procedures like LASIK.

Conference

ASCRS 2025: EVO ICL in low to moderate myopia may rival LASIK

Nordic Pharma, a subsidiary of Nordic Group BV, has announced a partnership with Harrow to launch an authorized generic of Maxitrol (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension), which treats and relieves bacterial eye infections, according to a news release.

"Today marks the culmination of months of work to bring this exciting new authorized generic to the marketplace. This product is a great addition to our generic portfolio, providing patients another affordable prescription option," said Thomas Sammler, vice president of Commercial Operations at Nordic Pharma, in the release.

Maxitrol has been the leading corticosteroid/antibiotic combination drop for the treatment of ocular inflammation and bacterial infections for more than 50 years, according to Harrow.

 Maxitrol and generic equivalents have a total of $20.8 million in annual sales in the US as of January 2025, according to IQVIA data.

The particular anti-infective drug in Maxitrol is active against common bacterial eye pathogens, including Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa. The product does not provide adequate coverage against Serratia marcescens and Streptococci, including Streptococcus pneumoniae.

“Ocular steroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of steroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation,” Harrow states in Maxitrol’s prescribing information. “They are also indicated in chronic anterior uveitis and corneal injury from chemical, radiation or thermal burns; or penetration of foreign bodies.”

Nordic Group BV through its subsidiary Nordic Pharma, Inc (US), announces launch of authorized generic of Maxitrol (neomycin and polymyxin B sulfates and dexamethasone ophthalmic suspension). News release. PR Newswire. April 24, 2025. Accessed April 29, 2025. 

https://www.prnewswire.com/news-releases/nordic-group-bv-through-its-subsidiary-nordic-pharma-inc-us-announces-launch-of-authorized-generic-of-maxitrol-neomycin-and-polymyxin-b-sulfates-and-dexamethasone-ophthalmic-suspension-302436485.html

Maxitrol. Harrow. Accessed April 29, 2025. 

Maxitrol has been the leading corticosteroid/antibiotic combination drop for the treatment of ocular inflammation and bacterial infections for more than 50 years.

Nordic Pharma partners with Harrow to launch an authorized generic of Maxitrol

Medtech company iSTAR Medical has announced positive 5-year data from its STAR-GLOBAL trial for the supraciliary minimally invasive glaucoma surgery (MIGS) device MINIject®.

 STAR-GLOBAL is an extension trial of the initial EU clinical trials investigating the long-term safety and efficacy of MINIject in patients with up to 5 years of follow-up, according to a news release.

“These very positive 5-year follow-up results provide further validation of MINIject as a safe, standalone procedure and an effective longer-term treatment option for glaucoma patients,” said Karsten Klabe, MD, chief surgeon at Breyer, Kaymak & Klabe Augenchirurgie, Düsseldorf, Germany, and a key investigator in the STAR trials, in the release. “This gives us further assurance that MINIject can continue to benefit to patients even half a decade post-surgery.”

Patients implanted with the MINIject were invited to enroll in STAR-GLOBAL upon completion of 2 years in the iSTAR Medical clinical trial, where follow-up with continue from 2 to 5 years. Data in the STAR-GLOBAL trial were obtained from 47 patients who completed the 5 years of follow-up from the STAR I, II, and III trials (83.9% of the 56 patients enrolled). The efficacy results indicated a sustained and significant 38% reduction of intraocular pressure (IOP) through 5 years. A majority (83%) of patients achieved a >20% reduction in IOP from baseline, with 80% having IOP of 18 or less at 5 years, and 32% of patients remaining medication free. A favorable safety profile for MINIject including corneal health was also confirmed at the 5-year follow up, with no serious adverse events related to the device or procedure in the STAR-GLOBAL follow up period.

“[These] 5-year follow-up data [are] highly encouraging, demonstrating the ability of iSTAR Medical’s MINIject to achieve sustained and significant lowering of IOP over the long term,” said Andrew Tatham, MD, FRCOphth, consultant ophthalmologist at Princess Alexandra Eye Pavilion and University of Edinburgh, UK, and President of the UK and Ireland Glaucoma Society, in the release. “This is consistent with the excellent safety and efficacy profile MINIject has already demonstrated in previous STAR trials.”

MINIject is currently the only commercially available supraciliary MIGS implant and has been implanted in more than 5000 patients since its launch.

“The strength and consistency of these 5-year results reinforces our belief that MINIject has the potential to become the surgical treatment of choice for glaucoma patients, offering a best-in-class solution for long-term glaucoma management,” Michel Vanbrabant, CEO of iSTAR Medical, said in the release. “iSTAR Medical remains committed to further validating this hypothesis in its future studies, positioning MINIject as the preferred surgical impact device among key opinion leaders, doctors, patients, and investors. With over 5000 patients now implanted, we continue to progress the development of MINIject to address a significant unmet need in key global markets.”

Additionally, iSTAR Medical noted in the release that it has ended its alliance with AbbVIE, which was announced in 2022. “iSTAR Medical continues to operate its business as usual as an independent company and remains well positioned to continue the development of MINIject in its ongoing US STAR-V trial with the aim of FDA submission in 2028 and the continued commercial roll-out in Europe and other global territories,” the company stated in the release.

iSTAR Medical’s MINIject demonstrates significant sustained 5-year efficacy in treating glaucoma in STAR-GLOBAL trial. News release. Morning Star. April 24, 2025. Accessed April 29, 2025. 

https://www.morningstar.com/news/globe-newswire/1001092047/istar-medicals-miniject-demonstrates-significant-sustained-5-year-efficacy-in-treating-glaucoma-in-star-global-trial

STAR-GLOBAL is an extension trial of the initial EU clinical trials investigating the long term safety and efficacy of MINIject in patients with up to 5 years of follow up.

Arsham Sheybani, MD

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